Hi
I've had Cervical Spondylosis ( C/S ) for over 30 years and because of my utter disillusionment with all the therapies I've encountered, both physiotherapy and medicinal, I've devised a self help guidance booklet to help with day to day activities for the long term C/S patient. I would appreciate any feedback on the contents of the advice booklet as shown below:

Cervical Spondylosis Self Management
A guide to managing your day

Cervical Spondylosis ( C/S ) is a confusing and disorientating medical condition. Symptoms will vary from person to person depending on different levels of wear and tear on the neck vertebrae. Because of this, and perhaps because it has been considered best to deal with C/S on an individual basis, it seems it has been difficult for the medical professionals to produce a guide book to general self management for the C/S sufferer, with day to day advice. The purpose of this booklet is to try and fill that gap.

The focus here will be on advice for managing, both practically and psychologically, at home and at work, and not on qualified physiotherapy, medications or surgery. The expertise of the professionals, whilst absolutely necessary at times of crisis, doesn’t always meet the everyday needs of C/S sufferers.

As a long time C/S sufferer myself, I have been only too aware of the typical despondency that lurks behind this condition. “ I get knocked down, I get up again “ should be our anthem. It’s a difficult road to travel and one of the ambitions of this guide would be to try and help develop an overview which puts despondency and creeping negativity into a perspective we can better handle. The guide will be in 4 parts, namely:

1. Activities and movements which might aggravate painful C/S symptoms.


2. Practical tips for managing painful symptoms.

3. Dealing with adverse social reactions.

4. Developing a positive overview of C/S.

Activities and movements which can aggravate painful C/S symptoms.

One of the problems with C/S is that the painful reaction to any aggravation is usually a delayed reaction. It will kick in after 2 or 3 days and may take weeks, even months, to resolve fully. So, it is wise to understand what the possible aggravators are and to avoid any painful consequences by being continually mindful of what activities or movements to avoid.

1. Lifting heavy weights:
This will vary from person to person, but a weight of 10 kgs or under should be ok for those with moderate C/S. For those with a more serious condition, it is best to avoid lifting any weights at all.



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2 Head movements:
Looking overhead, as in watching planes go by or admiring an ornate
ceiling, should be avoided. This movement may compress the neck vertebrae and might cause problems. Turning the head to look behind, or
to the side, as in car driving, can be another aggravator, especially if done quickly. Always be conscious of what seems to be the most comfortable position for the head and settle for that.


3. Working overhead:
Raising the arms above the shoulder horizontal, to do physical work, can
cause problems. Working directly overhead, as in repairing a ceiling
light socket, will definitely cause reactions. Painting or repairing
ceilings should be avoided. A good rule here is to try to be as close to, or
even above, the work you intend doing.

4. Sleeping in a draught:
Because the neck tends to be exposed, when we sleep, it is wise to
check for and eliminate any draughts in your sleeping environment. A
constant draught, playing on the neck, night after night, will exacerbate
any stiffness that already exists.

5. Driving:
Any jerky movements to look to the rear, or to the side can cause
problems. Simply reaching to the back seat, from the drivers seat can
set something off.

6: Gardening:
Any work with spade, shovel or fork seems to relay pressure to the
neck, and is best avoided. Again, any overhead trimming should also
be avoided.

7: Moving heavy furniture / bedding:
Trying to shift awkwardly shaped furniture or moving heavy bedding /
mattresses should be avoided, unless you have help.

8: Sleeping on a bad mattress / Using unsuitable pillow:
Either of these activities can worsen painful symptoms. They may
even be a cause of painful symptoms in the first place.





Practical Tips for managing C/S symptoms.

Again, because of the varying nature of C/S, some tips may work for some, and not for others. Trial and error are the only means of finding out which do and which
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don’t. Listed here are some, hopefully, useful tips which I’ve accumulated over several years and, whilst never resolving the problem, they go a long way in helping
provide a little comfort when symptoms kick in. Of course, the use of medications in conjunction with these tips, where necessary, should not be ignored.
Most of the tips and advice here are designed to try and help the C/S sufferer avoid reaching a critical point of pain endurance or toleration.



Headaches:

A typical C/S headaches usually comes, early in the morning, with mild disorientation and mugginess of thinking. Until the pain and mugginess have gone, it is almost impossible to concentrate on anything else. It usually appears shortly after rising and should be treated aggressively and quickly. If left untreated it can easily deteriorate throughout the day and become difficult to get rid of.

1 After rising, have a cup of tea first. Then take 2 nurofen, or similar, and wait half an hour before having a snack / breakfast. The pain should calm down within an hour and, because you’ve tackled it early, shouldn’t reappear throughout the day.
2 .It is important not to attempt to return to sleep, for the first few hours, as this seems to neutralise the effects and you may wake up with a headache again.
3 .If it is still bothering you in the afternoon, try taking a nap on a sofa with your head tilted slightly upwards, using pillow support. Another painkiller might also be useful if needed. The change of sleeping positions can produce positive results.
4 If you have continuous headache, over several days, try taking low dose painkillers every 4 hours, and use the tips above to try and break the cycle. Again, changing sleeping positions, from mattress to sofa, even during the night, can give results.

Frozen Shoulder:

Another unwelcome symptom of C/S. Typical symptoms are an inability to raise arms above shoulder height, or to the rear, without pain. It will last 10 months to 1 year and will then mysteriously disappear. It is mostly painful in the first 3 months and will cause problems with sleeping. It’s usually caused by stretching too far or lifting heavy weights or a combination of both.
1. For the first few months painkillers will be required. Best to take a couple 1 hour before bedtime.
2. If there is difficulty sleeping horizontally, sometimes the pain increases when lying down, then try getting comfortable on a sofa or armchair, keep warm, and just sleep as best you can.
3. Always try and find the most comfortable position and stick to it. Healing only happens with good rest.
4. After 3 months it should become manageable without resorting to painkillers.


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5. There are interventions such as surgery or steroid injections which might help if the pain is unbearable. But, the frozen shoulder will ease off gradually anyway and eventually disappear.




Trapped Nerve, Shoulder / Arm pain, Numb / Clumsy Hand.

This is a relatively recent one for me, but one a lot of long term sufferers have had to deal with. Ultimately, it is a neurological problem that may require surgical intervention. I don’t think anything can be achieved for the numb / clumsy hand, as yet, except by means of neck surgery. However, the shoulder / arm pain can be managed at home and, with a bit of luck, will disappear after a few months….a bit like the frozen shoulder scenario.
1. The shoulder / arm pain seems to increase with lying down. The only moderate comfort was achieved by draping the offending arm across top of head and snatching whatever sleep respite was possible. Painkillers were essential to resting.
2. A better sleep was achieved on a sofa, with regular changing of arm position and, of course, a couple of painkillers before bedtime, always taken with a light snack.
3. The shoulder / arm pain dissipated after 3 / 4 months and, almost immediately, the numb / clumsy hand appeared. With such an obvious symptom, although with little pain, I was fast tracked through MRI scans etc. to the neurological hospital for treatment. Although I have experienced much more painful symptoms over the years, this is the one that got me noticed , thus opening the door to available procedures and, at the same time, restoring my faith in the system somewhat..
4. It is possible to adjust to using the hand, over time, and, without much pain, it doesn’t really interfere with normal activities.


Sleeping:

1. A memory foam mattress, or mattress topper can greatly alleviate any aches from the shoulder down, and guarantees a better quality sleep. A bad or unsuitable mattress will do the opposite. Many C/S sufferers will testify that their aches have been halved and their comfort doubled by using memory foam.
2. Unfortunately, the same isn’t true of memory foam pillows. Due to their resistance and shape, they don’t seem to allow the neck to settle comfortably during sleep. There are specifically designed cervical pillows available, on the internet shopping sites, with more give, which are more suitable. We all await the perfectly designed C/S pillow patiently. A good pillow can mean the difference between a good day or a bad day.
3. Also, don’t believe it when people say that a hard mattress is good for your back. With C/S this simply isn’t true.

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4. Your sleeping environment is important. Check for any draughts, using a candle flame, and seal up any offending openings. Personally, I prefer to sleep on mattress on floor, rather than on bed, so the elimination of draughts is even more important, particularly during winter.


Driving:

1. Avoid jerking your head to look to rear or to side. Use mirrors as much as possible.
2. Don’t reach over to retrieve anything from back seat.
3. For ventilation, open passenger side window and make sure that driver’s window is properly sealed with no offending piercing draughts.
4. If tension from driving is increasing, just stop for 5 minutes and relax.



Carrying weights / moving furniture / gardening etc:

General rule here. If you feel any tension or pressure on the neck, stop what you’re doing and have a rethink. A helpful hand from someone else might spare you some painful repercussions.


Exercising:

Again, this will depend on the varying levels of C/S that individuals experience. If there was to be one rule, it should be to avoid any exercises which might aggravate the neck. No point doubling your worries and experience tells me that rest is always the safest healer. Anyone, who doesn’t have a physical lifestyle, should consider using the gentle neck movements that a physiotherapist would advise, just to keep some mobility going on and discourage any possible neck stiffness. Overdoing it may cause it’s own problems. Personally, I believe, that a better understanding of the causes of aggravation will render any exercises unnecessary. There, even if none of the other tips in this guide should work, at least I’ve offered a good excuse for not exercising ! And that’s probably the only humour you will encounter if you choose to carry on reading.


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Dealing with adverse social reactions.


Doubts:

My experiences have informed me that it appears difficult for others to understand or accept the complications that come with C/S and, consequently, it’s quite common for the sufferer to find themselves on the receiving end of adverse reactions. There are probably many ways of dealing with these, but most important is to not let the doubts of others become your doubts. The transference of disbelief can undermine your understanding of your own condition and interfere with your resolve to try and better your situation. My advice here would be to dismiss any third party doubts you encounter and try to stay focused on your own needs.

Expectations:

Before any of us developed C/S, we experienced the expectations, ambitions, even dreams associated with a normal healthy lifestyle. With C/S this can all change. Human nature dictates that we cling on to these expectations and aspirations despite our new awareness that most are now beyond our capacity to achieve. Perhaps it would be best to re-evaluate these goals into more achievable ambitions, like a simple desire for maximum comfort and, maybe, a clear head to plan the future.

Uncertainty after medical appointments:

This was always a low point for me, although I should say that in the last year I have been treated and advised really well. Many times, over the years, I have left the GP’s, or the hospital, with a confused gut feeling that the advice I was receiving was designed to coax me into thinking that the painful symptoms I had were, somehow, not real. Recently I have been treated much more openly and honestly, and the difference that makes to my state of mind and how I perceive the whole C/S dilemma, has been an amazing eye opener. My advice here is to develop a healthy scepticism and keep pressing until you find someone whose knowledge and advice you trust. There’s no guarantee that, the further up the hierarchy you go, the better things will get . So, cherish the good ones you find along the way.


Planning social events:

Just one simple thing to consider here. C/S is unpredictable, on a day to day basis. One day you may feel ok and want to make up lost ground socially. The next day, you feel bad, and must cancel any arrangements made in good faith. Not easy to remain convincing if this happens on a regular basis. Probably best to let your friends know that, as a rule, you will only make your decision for socialising, on the day, and spare yourself the trouble and worry of endless cancellations. Works for me.



Thank you for reading this

Gerry the Neck






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